As a licensed medical professional who has completed advanced specializations such as forensic nursing programs, you’ll likely come across patients who have been victims of violence.
Indeed, domestic and intimate partner violence is shockingly common in the US, with nearly 12 million Americans enduring this type of abuse every year.
But as a nurse practitioner, how do you recognize and identify the tell-tale signs of abuse in your patients? Perhaps more importantly, once you have ascertained that your patient could be a victim of violence, how do you best support them?
Let’s discuss.
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Recognize and Identify the Signs of Abuse
Being able to determine whether a patient is experiencing abuse is a central element of caring for them as their medical professional.
One of the key signs of intimate partner violence that a nurse must look out for is if a patient frequently presents with unexplained pain or injuries. Another alarm bell? Recently developed onsets of mental health conditions such as depression, anxiety, or insomnia.
More subtle signs a patient could be an abuse victim can include social withdrawal, cutting off contact with family and friends, or being required to ask permission from a partner before making any decisions.
Needless to say, a nurse would need to dig deeper to identify the more subtle signs of abuse. One strategy nursing professionals can employ to do so is to perform the HARK questionnaire. This is a series of questions that can assist a medical professional in ascertaining whether their patient is a victim of the following types of abuse;
Humiliation
This section of the questionnaire aims to identify if the patient has been subjected to humiliation or emotional abuse.
Afraid
Here, the medical professional must ascertain if the patient has ever felt afraid of their partner.
Rape
This question relates to whether the patient has been forced into non-consensual sexual activity.
Kick
This part of the questionnaire aims to uncover whether the patient has experienced physical abuse.
Each section of the HARK questionnaire is heavily weighted and can be used to determine whether the medical professional needs to intervene and provide support to the victim.
Provide a Safe, Supportive, and Nonjudgmental Space
To best support victims of domestic or intimate partner violence, nursing professionals must provide a safe and supportive space for their patients to be able to open up to them.
For the nurse in question, this means being able to listen with empathy and without judgment and to provide unbiased and measured advice relating to the patient’s situation.
This, of course, also requires the nurse practitioner to be able to establish trust with patients and facilitate open and transparent conversations.
The nurse also must ensure the patient feels both empowered and cared for when they are sharing details about their experience.
Educate and Connect Patients to Resources
Once they have identified that a patient is being subjected to abuse, it is the responsibility of the medical practitioner to connect the victim to educational and support resources – such as, for example, the National Domestic Violence Hotline.
Other resources healthcare professionals can connect their patients to include community support groups, licensed counselors and psychologists, or if deemed necessary, law enforcement authorities.
On the subject of law enforcement in terms of regulating domestic and intimate partner violence, this is a contentious issue.
While many voices of authority on the matter continue to push for the mandatory reporting of intimate partner violence when witnessed by a medical professional, the truth is that this can be a difficult thing to enforce.
For nursing professionals seeking to provide better support to patients who have been victims of violence, the strategies we have outlined today can be effective starting points.
As discussed, the first step is to recognize and identify the signs of abuse – whether they are unexplained injuries or the recent development of a new mental health condition.
Next, nursing practitioners must provide a supportive environment in which victims can feel both empowered and safe enough to share the details of their situation.
Lastly, one of the best ways a nurse can support a victim is to connect them with educational and support resources, such as community groups, therapists, and law enforcement bodies.